Fri Nov 11 2022

68 articles - From Friday Nov 04 2022 to Friday Nov 11 2022

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…

Am J Gastroenterol

A Stitch in Time: Rethinking the Rationale for Empiric PPIs in the ACG GERD Guideline.

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Meta-analysis

meta-analyses and systematic reviews


Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Application of CT contrast medium is not associated with an increased risk for acute kidney injury in patients with decompensated cirrhosis.

Decompensated cirrhosis per se should not preclude diagnostic CM-CT.

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Sleep duration and daytime napping in relation to incident inflammatory bowel disease: a prospective cohort study.

This study reveals positive associations between short sleep duration and daytime napping and IBD risk.

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Am J Gastroenterol

A Randomized, Dose-Finding, Proof-of-Concept Study of Berberine Ursodeoxycholate in Patients With Primary Sclerosing Cholangitis.

HTD1801 is associated with significant improvement in ALP and warrants further study as a treatment for PSC.

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Berberine Ursodeoxycholate for the Treatment of Primary Sclerosing Cholangitis: The Search for the Elusive Pharmacologic Holy Grail Will Need to Continue.

Although improvement in serum alkaline phosphatase is reported, without a control arm with UDCA monotherapy, it is not possible to determine whether this study drug is beneficial over UDCA by itself. More study in the PSC therapeutic arena is needed.

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Gastroesophageal Reflux Disease Is Not a Great Screening Criterion: Time to Move on to Other Strategies for Controlling the Burden of Esophageal Adenocarcinoma.

This is likely due to a conflation among providers regarding diagnostic EGD in those with refractory symptoms and screening EGD. An alternative approach is needed that de-emphasizes GERD to avoid confusion and increase uptake of appropriate screening.

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Inflammatory Bowel Disease-Associated Colorectal Cancer Epidemiology and Outcomes: An English Population-Based Study.

IBD-associated CRCs occur in younger patients and have worse outcomes than sporadic CRCs. There is an urgent need to find reasons for these differences to inform screening, surveillance, and treatment strategies for CRC and its precursors in this high-risk group.

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Longitudinal Associations of Risk Factors and Hepatocellular Carcinoma in Patients With Cured Hepatitis C Virus Infection.

Risk factors for HCC were different in patients with and without cirrhosis and some also evolved during follow-up. These factors can help with risk stratification and HCC surveillance decisions in patients with cured HCV.

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Clin Gastroenterol Hepatol

Cardiovascular outcomes in patients with biopsy-proven alcohol-related liver disease.

Persons with biopsy-proven ALD have increased rates of CVD across histological subgroups compared to matched reference individuals, particularly just after ALD diagnosis. Active surveillance of modifiable CVD risk factors should be considered by clinicians treating patients with ALD.

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Comparative Safety and Effectiveness of Biologic Therapy for Crohn's Disease: A CA-IBD Cohort Study.

In a multicenter cohort of biologic-treated patients with CD, ustekinumab was associated with lower risk of serious infections compared with TNFa antagonists and vedolizumab, without any differences in risk of hospitalization or surgery. Risk of serious infections was similar for TNFa antagonists vs vedolizumab.

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GLIMMER: A randomized Phase 2b dose-ranging trial of linerixibat in primary biliary cholangitis patients with pruritus.

Linerixibat effect on itch was not significantly different versus placebo in the primary intent-to-treat analysis but was associated with a significant dose-dependent reduction in itch in the per protocol population. A well-tolerated dose was identified for Phase 3 investigation for cholestatic pruritus in PBC. ID NCT02966834.

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Hybrid- and conventional endoscopic submucosal dissection for early gastric neoplasms: a multi-center randomized controlled trial.

H-ESD has significantly shorter procedure time than C-ESD, with high and comparable curability and safety for both H-ESD and C-ESD. H-ESD can be a good option for the endoscopic treatment of small EGNs.

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Incidence, management and outcomes of very early onset inflammatory bowel diseases and infantile-onset disease: an epi-IIRN study.

The incidence of VEOIBD remained stable. Infantile-onset IBD had worse outcomes than older children while the toddler-onset had mostly similar outcomes, despite less frequent use of biologics.

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Linked-color imaging detects more colorectal adenoma and serrated lesions: an international randomized controlled trial.

Compared to WLI, LCI improved adenoma and other polyps' detection rates, including SSLs, resulting in alteration of the recommended surveillance schedule after screening, diagnostic, and post-polypectomy surveillance colonoscopy.

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Role Of Oral Health, Frailty and Minimal Hepatic Encephalopathy In The Risk Of Hospitalization: A Prospective Multi-Center Cohort Of Outpatients with Cirrhosis.

CONCLUSIONS: In a contemporaneous prospective, multi-center cohort study in outpatients with cirrhosis, poor oral health is significantly associated with 3-month hospitalizations independent of portal hypertensive complications, MHE and frailty. Potential strategies to reduce hospitalizations should consider oral evaluation in addition to MHE and frailty assessment in practice pathways.

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Gastrointest Endosc

Analysis of variation in learning curves for achieving competency in convex endoscopic ultrasound training: A prospective cohort study using a standardized assessment tool.

Our results showed that theoretical knowledge, rather than the number of EUS cases, may be a possible influencing factor for distinguishing high and low performers after treating 250 cases.

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Impact of peroral endoscopic myotomy on high-resolution manometry findings and their association with the procedure's outcomes.

Extended gastric myotomy decreased IRP values, while peristalsis recovery depended on the characteristics of achalasia. A residual high post-POEM IRP does not necessarily mean clinical failure. Routine HRM follow-up is not recommended after POEM.

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Prophylactic EUS-guided gallbladder drainage prevents acute cholecystitis in patients with malignant biliary obstruction and cystic duct orifice involvement: A randomized trial (with video).

In this single center study of patients with unresectable MBO and occlusion of the cystic duct orifice, prophylactic EUS-guided gallbladder drainage demonstrated a reduced incidence of acute cholecystitis.

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The effect of ursodeoxycholic acid following self-expandable metallic stent placement in malignant distal biliary obstruction: A propensity score-matched cohort analysis.

Administering UDCA after SEMS was not efficacious for prolonging the TRBO in MDBO. Moreover, administering UDCA beyond a month might increase the risk of stent sludge occlusion.

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The Role of Through-The-Scope Catheter-Based Endoscopic Ultrasound In Inflammatory Bowel Disease Diagnosis and Activity Assessment.

EUS measurements of colon wall layers can help diagnose active CD versus UC and assess transmural disease activity.

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Gut

Hepatic encephalopathy is not a contraindication to pre-emptive TIPS in high-risk patients with cirrhosis with variceal bleeding.

pTIPS is associated with better survival than endoscopic treatment in high-risk patients with cirrhosis with variceal bleeding displaying HE at admission.

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Hypophosphataemia following ferric derisomaltose and ferric carboxymaltose in patients with iron deficiency anaemia due to inflammatory bowel disease (PHOSPHARE-IBD): a randomised clinical trial.

Despite comparably effective treatment of IDA, FCM caused a significantly higher rate of hypophosphataemia than FDI. Further studies are needed to address the longer-term clinical consequences of hypophosphataemia and to investigate mechanisms underpinning the differential effects of FCM and FDI on patient-reported fatigue.

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Longitudinal transkingdom gut microbial approach towards decompensation in outpatients with cirrhosis.

In this longitudinal study of cirrhosis outpatients, the greatest transkingdom gut microbial changes were seen in those reaching the first decompensation, compared with subsequent decompensating events. A transkingdom approach may refine prediction and provide therapeutic targets to prevent cirrhosis progression.

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J Hepatol

Hepatic and renal improvements with FXR agonist vonafexor in individuals with suspected fibrotic NASH.

In patients with suspected fibrotic NASH, Vonafexor was safe and induced potent liver fat reduction, improvement in liver enzymes, weight loss, and a possible renal benefit. Clinical trial number (eudract) 2018-003119-22. Clinicaltrials Gov identifier NCT03812029. Impact and implications NASH has become a leading cause for chronic liver disease and patients are also at higher risk for the development of chronic kidney disease. There are no approved therapies and only few options to treat this population. LIVIFY Phase 2a trial results show that single daily administration of oral Vonafexor, a FXR agonist, leads in the short term to a reduction in liver fat, liver enzymes, fibrosis biomarkers, body weight and abdominal circumference, and a possible improvement in kidney function, while possible mild moderate pruritus (a peripheral FXR class effect) and an LDL-Cholesterol increase are manageable with lower doses and statins. These results support exploration in longer and larger trials to ultimately provide therapies for the unmet medical need in NASH.

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Overall survival and objective response in advanced unresectable hepatocellular carcinoma: A subanalysis of the REFLECT study.

Objective response was an independent predictor of OS in individuals with unresectable HCC in REFLECT; additional studies are needed to confirm surrogacy. Participants achieving a complete or partial response by mRECIST or RECIST v1.1 had significantly longer survival vs those with stable/progressive/non-evaluable disease. Clinicaltrials Gov number NCT01761266. Impact and implications This analysis of data taken from a completed clinical trial (REFLECT) looked for any link between objective response and overall survival time in individuals with unresectable HCC receiving anti-angiogenic treatments. Significantly longer median overall survival was found for responders (21.6 months) vs non-responders (11.9 months). Overall survival was also significantly longer for responders vs non-responders (based on objective response status at 2, 4, and 6 months) in the landmark analysis. Our results indicate that objective response is an independent predictor of overall survival in this setting, confirming its validity as a rapid marker of efficacy that can be applied in phase II trials; however, further validation is required to determine is validity for other systemic treatments (e.g. immunotherapies), or as a surrogate of overall survival.

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Survival benefit of adequate lymphadenectomy in patients undergoing liver resection for clinically node negative intrahepatic cholangiocarcinoma.

and relevance Adequate lymphadenectomy provided better survival outcomes for cN0 patients who were found to be node-positive at pathology, supporting the routine use of adequate lymphadenectomy for cN0 intrahepatic cholangiocarcinoma. Impact and implications Lymphadenectomy (LND) is essential for the surgical staging of intrahepatic cholangiocarcinoma (ICC). While its role in patients with preoperative suspicion of nodal metastases is implicit, the impact of LND on survival of clinically node-negative (cN0) patients is still under debate. In this large retrospective study on cN0 patients who underwent surgical resection for ICC, we show that performing an adequate LND by retrieving 6 or more lymph nodes significantly improves survival and lowers the risk of tumor recurrence. Lymphadenectomy during surgical resection of ICC is actually underperformed by the surgical community, resulting in inadequate staging and possibly in worse long-term outcomes. The results of this study empower surgeons and clinicians in claiming an adequate lymphadenectomy even in cN0 patients. Since patients with no chronic liver disease and with less advanced tumors are those who receive a significant benefit from LND, our results might guide decision making in patients at high-risk for postoperative complications.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Editorial: food insecurity, diet quality, racial and ethnic disparities in non-alcoholic fatty liver disease.

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Editorial: gluten-free but not pain-free in IBS.

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Editorial: implications and future perspectives of the increase in biologics use in paediatric inflammatory bowel disease.

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Editorial: what is needed to achieve success in developing diagnostic technologies for patients with gastrointestinal motility disorders - past and present.

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Review article: the role of HSD17B13 on global epidemiology, natural history, pathogenesis and treatment of NAFLD.

The loss-of-function polymorphisms of the newly identified HSD17B13 gene mitigate the progression of NAFLD. It is important to understand the exact mechanism by which these variants exert a protective effect and implement the gathered knowledge in the treatment of NAFLD.

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Gastroenterology

Fibrosis and Inflammation in Inflammatory Bowel Disease-More Than 2 Sides of the Same Coin?

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Have We Found the "Holy Grail" That May Predict Response to Immunotherapy in Hepatocellular Carcinoma?

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Potassium-Competitive Acid Blocker Suppression of Gastric Acid in Erosive Esophagitis: Is Stronger and Longer Better?

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The "Next Generation" of Pancreatic Cyst Fluid Biomarkers?

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Gastrointest Endosc

Is endoscopic sleeve gastroplasty ready for prime time?

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J Hepatol

NASH Cirrhosis Trials And Major Adverse Liver Outcomes: Big Data Needed.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

Calendar of Courses, Symposiums and Conferences.

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Correction to: Biochemical Diagnosis of Bile Acid Diarrhea: Prospective Comparison With the 75Seleno-Taurohomocholic Acid Test.

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Response to Graham.

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Response to Rajendra.

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Endoscopy

Anchoring endoscopic mucosal resection for colorectal polyps - keep this weapon in mind.

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Optimizing referral practices for resection of large colorectal polyps.

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Gastroenterology

A Rare but Devastating Dermatologic Manifestation of Ulcerative Colitis.

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Comparative Performance of Artificial Intelligence Optical Diagnosis Systems for Leaving-In-Situ Colorectal Polyps.

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Picking a zebra among horses: More difficult than you think!

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Recurrent Abdominal Pain in a 61-Year-Old Woman.

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Severe chronic rectocolitis associated with a characteristic "sunflower MR-imaging pattern".

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Gastrointest Endosc

Impact of margin ablation after Endoscopic Mucosal Resection of large non pedunculated colonic polyps in routine clinical practice.

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Pseudosarcomatous lesion mimicking malignant tumor, successfully removed by endoscopic submucosal dissection.

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Gut

Gnotobiotic mice housing conditions makes the difference in the context of obesity!

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Health-code-based triage versus universal COVID-19 PCR testing before endoscopy in a low incidence area: a real-world experience.

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Letters&Replies

Letters to the editors and authors’ replies

Aliment Pharmacol Ther

Editorial: gluten-free but not pain-free in IBS-authors' reply.

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Editorial: what is needed to achieve success in developing diagnostic technologies for patients with gastrointestinal motility disorders - past and present. Authors' reply.

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Letter: vaccination for global control of hepatitis B-from prevention to elimination.

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Letter: vaccination for global control of hepatitis B-from prevention to elimination. Authors' reply.

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Clin Gastroenterol Hepatol

Anti-TNF withdrawal in inflammatory bowel disease with endoscopic healing and the Risk of Relapse- Authors' response.

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Concentrating on the long topic of empirical or not conventional Helicobacter pylori eradication regimens.

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Gastroenterology

A composite microbe-metabolite diagnostic panel: Still needed further discussion.

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Gut

Diameter of the shunt: the missing link in the appraisal of pTIPS in patients with cirrhosis with previous hepatic encephalopathy.

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Gut microbiota as non-invasive diagnostic and prognostic biomarkers for natural killer/T-cell lymphoma.

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Non-alcoholic fatty liver disease (NAFLD) is associated with an increased incidence of extrahepatic cancer.

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Reply: Immortal time bias in a retrospective study examining colorectal cancer mortality according to adherence to colonoscopy.

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J Hepatol

Attitudes toward liver transplantation for ACLF-3 patients determine equity of access.

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Cases of severe acute liver injury following inactivated SARS-CoV-2 vaccination.

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Reply to 'Ammonia and prognosis of cirrhosis: a new perspective for identifying high risk patients'.

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Reply to 'The possible link between higher ammonia levels associated with non-alcoholic fatty liver related cirrhosis and diabetes: are we missing chronic kidney disease?'

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Reply to: 'Depiction of alcohol-related liver disease in the EASL International Liver Congress'.

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